Patient Monitoring And Repositioning System And Related Method

ABSTRACT

A patient monitoring and repositioning system ( 10   a ) includes a mattress ( 26 ), a sheet ( 16 ) residing on an upper surface of the mattress ( 26 ), a housing ( 29 ) containing a drive mechanism ( 28 ), and a sensor ( 20 ) adapted to sense a position of a patient ( 22 ) resting on the mattress ( 26 ). The drive mechanism ( 28 ) is operable to pull the sheet ( 16 ) and thereby pull the patient ( 22 ) resting thereon. The housing ( 29 ) receives the sheet ( 16 ) through a slot ( 54 ). In the event that the patient ( 22 ) is in an undesirable position on the mattress ( 26 ) as detected by the sensor ( 20 ), a controller ( 24 ) directs the drive mechanism ( 28 ) to pull the sheet ( 16 ) so as to pull the patient thereon from the undesirable position to a desirable, predetermined position. The controller ( 24 ) may direct the drive mechanism ( 28 ) automatically or indicate the undesirable position to a caregiver so that the caregiver may direct the drive mechanism ( 28 ) accordingly.

RELATED APPLICATIONS

This application claims priority to U.S. Provisional Patent ApplicationNo. 61/952,380, entitled “Patient Monitoring/Repositioning System,”filed on Mar. 13, 2014, which is expressly incorporated by referenceherein in its entirety. Applicant's currently pending U.S. patentapplication Ser. No. 13/837,185, filed Mar. 15, 2013, entitled “PatientRepositioning System” (“the '185 application”) is also expresslyincorporated by reference herein, in its entirety.

FIELD OF THE INVENTION

The present invention relates to patient repositioning, and moreparticularly, to a system that reduces and relieves interface pressuresbetween a patient and a bed support surface by reducing concentratedforces on the patient, such as friction and shear forces, in order toreduce the likelihood of discomfort, pressure ulcers, and/or otherinjuries to the patient.

SUMMARY OF THE DISCLOSURE

Applicant's presently pending '185 application discloses various detailsand embodiments of a patient repositioning system wherein the systemmoves a sheet and the patient supported thereon toward a head end of thebed, such as a healthcare bed that articulates to improve patientcomfort. The '185 application discloses numerous features and detailsrelated to the general concept of patient repositioning in this manner,such as the sheet having a width greater than that of the mattress.

Nonetheless, the '185 application focuses on reducing and simplifyingthe efforts needed by a caregiver to reposition a patient toward a headend of the bed. Generally, the caregiver repositions the patient byphysically activating the inputs to the system, and those inputs arepart of, or at least associated with, a sheet receiver located partiallybelow the top surface of the mattress.

The present disclosure focuses on additional aspects of the patientrepositioning system shown in the '185 application. That is, the presentdisclosure focuses on a patient monitoring and repositioning system fordetecting and identifying the need to reposition a patient, prior to theactual repositioning of the patient via such a patient repositioningsystem. This feature is helpful in reducing the occurrence of pressureulcers with the patient, which could otherwise be caused by the patientremaining in an undesirable position rather than a desirable,predetermined position on the mattress. According to various embodimentsof the patient monitoring and repositioning system disclosed herein,there is no need for a caregiver to be physically present, next to thebed, to detect that a patient has migrated down in the bed to anundesirable position and needs to be repositioned to a desirableposition, which may also be referred to herein as a predeterminedposition or a normal position. Rather, the need for repositioning can becommunicated to the caregiver via an alarm and/or some other indicatoror call system, or it could be addressed automatically at the bed, withor without an alarm or indicator.

Once the need to reposition the patient has been detected, then thatneed can be addressed in any one of several ways. For example, themonitoring system can communicate to the repositioning system toautomatically reposition the patient. Alternatively, the monitoringsystem can communicate the need for patient repositioning withoutprompting the repositioning system to automatically reposition thepatient, such as requesting human intervention to reposition the patientat the bed-side, or requesting remote activation from a separatelocation, a central control station in another portion of the building,or even miles away at another location. In the context of thisspecification, a controller may be located on or near the bed orremotely from the bed for communicating with the bed via a wired or awireless connection. With such remote patient repositioning capabilitiesand a plurality of such patient repositioning systems in place in asingle facility, any desired number of such repositioning systems couldbe monitored and activated at the same time. Thus, any desired number ofpatients could be remotely repositioned at the same time, withoutrequiring a like number of caregivers to interact with eachrepositioning system. However, for practical reasons, it may be that theactual patient repositioning is not performed remotely, but is insteadinitiated by a caregiver, or by the patient, who is physically present.But even in that case, the caregivers can be more efficient with theiravailable time, because the present system is capable of simultaneouslydetecting, identifying, and communicating the need for repositioning ofpatients to one or more caregivers. In other words, this disclosurefocuses on the coupling of a monitoring system for detecting patientposition with a repositioning system for repositioning the patient, sothat ultimately the patient can be repositioned, whether remotely orwith a caregiver physically present. In addition, the control system,such as a central control system in the form of a hospital informationsystem, operatively connects to the patient monitoring and repositioningsystem. The control system may further monitor the patient not being inthe predetermined position, a time that the patient is not in thepredetermined position, an amount of patient repositionings, a frequencyof patient repositionings in a facility, an amount of sheet alreadyused, a need to change or reset the sheet on the bed, a distancemigrated by the patient on the bed, a time of the patient in eachposition on the bed, a time delay before repositioning the patient onthe bed, a duration of repositioning the patient on the bed, a positionof the patient on the bed, a time of day the patient was repositioned,and a frequency of patient repositionings executed on the bed.

According to one aspect of a patient monitoring and repositioning systemof the type disclosed herein, each of a plurality of patientrepositioning systems (of the type disclosed in the '185 application) ispreferably equipped with a sensor arrangement for sensing the positionof the patient. The sensor arrangement could employ one or more loadcells, infrared beams, capacitors, resistors, cameras with imagedetection, magnets, or any other type of structure for sensing theposition of the patient on the mattress (e.g., acoustic, sonar,ultrasonic, etc.).

According to another aspect of the invention, with the sensorarrangement in place, and operatively connected to the drive mechanism,and the sensor arrangement also operatively connected to an alarm and/ora control system, the monitoring system senses when the patient hasmoved toward the foot end of the bed. More particularly, the sensorarrangement senses substantially the entire top surface of the mattressfor sensing patient movement. When such patient moves toward the footend from the desirable position to the undesirable position, and thesensor arrangement detects and signals that the patient has moved towardthe foot end of the bed, the monitoring system automatically requeststhe repositioning system to reposition the patient and/or uses anindicator, such as an alarm, to communicate the need to reposition thepatient to the caregiver. As such, the indicator operatively indicatesthe position of the patient relative to the mattress at all times duringuse. Any one or more of a number of different types of visual and/oraudible indicators may be used. For example, the indicator may be adisplay, one or more LEDs, a graphic display message, an audible signal,a wired transmission message, a wireless transmission message, and/or aparallel or serial message. Thereafter, the patient can be repositionedtoward the head end of the bed automatically or either via remoteactuation of the drive mechanism without a caregiver physically presentproximate to the bed, or via actuation of the drive mechanism by thecaregiver who is physically present proximate to the bed via a userinterface. This repositioning can then also be detected by themonitoring system to indicate that a logical sequence of events has beencompleted, and that the patient is in the predetermined position. Oncethe patient has been restored to the predetermined position, themonitoring system ceases to indicate and/or communicate the need toreposition the patient. The monitoring system may alternatively oradditionally communicate that the patient was repositioned.

Still further, with a plurality of such patient monitoring andrepositioning systems of this type in use in a facility, and operativelyconnected to a central control station, the central control station canenable the operator of the facility to monitor various events andparameters, including the patient not being in the predeterminedposition, a time that the patient is not in the predetermined position,an amount of patient repositionings, a frequency of patientrepositionings in a facility, an amount of sheet already used, a need tochange or reset the sheet on the bed, a distance migrated by the patienton the bed, a time of the patient in each position on the bed, a timedelay before repositioning the patient on the bed, a duration ofrepositioning the patient on the bed, a position of the patient on thebed, a time of day the patient was repositioned, and a frequency ofpatient repositionings executed on the bed.

In use, according to an exemplary embodiment, the patient rests on amattress, but slides from the predetermined position toward the foot endof the bed to an undesirable position. The sensor arrangement detectsthe undesirable position of the patient and identifies the need toreposition the patient from the undesirable position to thepredetermined position. A controller, operatively connected to thesensor arrangement, automatically directs the drive mechanism to pullthe sheet toward the head end and, in turn, return the patient to thepredetermined position. Alternatively, according to another exemplaryembodiment, the controller, operatively connected to the sensorarrangement, is further connected to an indicator, such as an audiblealarm. The controller activates the audible alarm in order to indicateto a caregiver that the patient has moved to an undesirable position. Inturn, the caregiver operatively actuates the drive mechanism to pull thesheet toward the head end and, in turn, return the patient to thepredetermined position. The caregiver may operatively actuate the drivemechanism by interacting with a user interface proximate to the bed orby remotely directing the drive mechanism. In turn, the audible alarm isdeactivated to signal that the patient is in the desirable position. Byway of example, the above scenarios may be completed by the patientrepositioning system disclosed in the '185 application in conjunctionwith the patient monitoring and repositioning system described herein.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a diagram of a plurality of patient monitoring andrepositioning systems operatively connected to a hospital informationsystem via a network according to a first exemplary embodiment of theinvention.

FIG. 2 is a diagram of a sheet receiver of a patient monitoring andrepositioning system operatively connected to a network as shown in FIG.1.

FIG. 3A is a side view of the patient monitoring and repositioningsystem of FIG. 1 with a patient in an undesirable position on a healthcare bed.

FIG. 3B is the side view similar to FIG. 3A, but with the patient in adesirable, predetermined position on the health care bed.

FIG. 4 is a schematic perspective view of the patient monitoring andrepositioning system according to the first exemplary embodiment of theinvention.

FIG. 5A is a schematic section view of an embodiment of a sensor of thepatient monitoring and repositioning system shown in FIG. 4.

FIG. 5B is a schematic section view of another embodiment of a sensor ofthe patient monitoring and repositioning system shown in FIG. 4.

FIG. 6 is a schematic perspective view of a patient monitoring andrepositioning system according to a second exemplary embodiment of theinvention.

FIG. 7 is a schematic perspective view of a patient monitoring andrepositioning system according to a third exemplary embodiment of theinvention.

FIG. 8A is a schematic section view of a sensor of the patientmonitoring and repositioning system shown in FIG. 7.

FIG. 8B is a schematic section view of the sensor shown in FIG. 8Adepressed by a force of a patient thereon.

FIG. 9 is a schematic perspective view of a patient monitoring andrepositioning system according to a fourth exemplary embodiment of theinvention.

DETAILED DESCRIPTION OF THE DRAWINGS

With reference to FIGS. 1-3B, a patient monitoring and repositioningsystem 10 a includes a sensor arrangement 12 a, a sheet receiver 14 a,and a sheet 16 for use with a health care bed 18. The sensor arrangement12 a is more particularly a plurality of sensors 20 configured to detecta position of a patient 22 resting on the health care bed 18. The sensorarrangement 12 a is at least one sensor 20, which senses the position ofthe patient 22 and indicates to a controller 24 whether or not thepatient 22 is in a desirable, predetermined position relative to amattress 26 of the health care bed 18. In the event that the patient 22migrated along the mattress 26 to an undesirable position, which mayalso be referred to herein as not being in the predetermined position,the controller 24 automatically signals a drive mechanism 28 within ahousing 29 of the sheet receiver 14 a to pull the sheet 16 and, in turn,pull the patient 22 resting on the sheet 16 until the patient 22 returnsto the predetermined position. As an alternative to automaticrepositioning by the controller 24, the caregiver may direct thecontroller 24 to pull the sheet 16, such as in response to one or moreindicators 30, 32, 34 described below in additional detail. As describedherein, the term “predetermined position” means the desirable positionand/or range of positions relative to the mattress 26 in which thepatient 22, resting on the mattress 26, benefits from a reducedlikelihood of injury, such as by pressure ulcers, and an increasedlikelihood of patient comfort. This desirable position and/or range ofpositions may refer to the patient's translational position relative tothe mattress 26, the patient's rotational position relative to themattress 26, or any combination thereof. To this end, the predeterminedposition may be an approximation based on a typical patient or tailoreduniquely to a particular patient. Similarly, the term “undesirableposition” generally refers to any patient position on the mattress 26 inwhich the patient 22 is not within the predetermined position.Furthermore, it will be appreciated that the term “sense” with respectto the sensor arrangement 12 a may refer to actively sensing the patient22 in both the predetermined position and the undesirable position oractively sensing the patient 22 in only one of the predetermined andundesirable positions. As such, the patient monitoring and repositioningsystem 10 a may infer the patient position if the patient is notactively sensed by the sensor arrangement 12 a. The term “sense” is thusnot intended to be limited to only actively sensing the patients 22.Thus, according to one embodiment, the controller 24 continuously sensesthe position of the patient relative to the mattress 26 while thepatient 22 rests on the mattress 26.

With respect to FIG. 1, a plurality of the patient monitoring andrepositioning systems 10 a, 10 b, 10 n may be operated within a singlehealth care facility or throughout multiple health care facilities. Eachof the patient monitoring and repositioning systems 10 a, 10 b, 10 nincludes respective sensor arrangements 12 a, 12 b, 12 n and sheetreceivers 14 a, 14 b, 14 n. The sheet receivers 14 a, 14 b, 14 noperatively connect to a network 36, which also operatively connects toa control system 38. The control system 38 is more particularly acentral control system 38, such as a hospital information system 38. Thehospital information system 38 may include a data information system,data management system, intranet, and/or software that interfaces with ahospital scheduling system, conventional web server, e-mail server, orany other software configured to indicate information concerning thepatient monitoring and repositioning system 10 a to the caregiver. Thehospital information system 38 is typically a device that includes aprocessor, a memory, and a network interface and may commonly bereferred to as a computer. From the hospital information system 38, oneor more caregivers may receive indications of patient position, verifyautomatic repositioning of the patients by the patient monitoring andrepositioning systems 10 a, 10 b, 10 n, verify repositionings of thepatient 22 by the caregiver located at the bedside and/or direct thepatient monitoring and repositioning systems 10 a, 10 b, 10 n to performpatient repositioning as desired. Thus, the sheet receivers 14 a, 14 b,14 n and the hospital information system 38 are configured tocommunicate back and forth via the network 36. It will be appreciatedthat any number of patient monitoring and repositioning systems 10 a, 10b, 10 n may be used in accordance with the principles discussed herein.

The sheet receiver 14 a, as shown in FIGS. 2-3A, includes the controller24 operatively connected to the drive mechanism 28, safety interlock 40,and a transceiver 42 contained within the housing 29. As shown, thecontroller 24 is in the sheet receiver 14 a; however, the controller 24may alternatively be positioned remotely from the sheet receiver 14 a.The sheet receiver 14 a also includes a user interface 44 operativelyconnected to the controller 24 and has the indicators 30, 32, 34 andinput switches 46 configured for use by the caregiver to direct thecontroller 24. The indicators 30, 32, 34 are more particularly in theform of a display 30, such as a graphic touchscreen panel, one or morelight emitting diodes (“LEDs”) 32, and one or more audible alarms 34 forindicating information to the caregiver. In one embodiment, at least oneof the indicators 30, 32, 34 is configured to indicate to the caregiverthat the patient 22 is in the predetermined and undesirable positions.Alternatively, one of the indicators 30, 32, 34 may only indicate theposition of the patient 22 when the patient 22 is either in thepredetermined position or the undesirable position.

The transceiver 42 sends information to and receives information fromthe network 36 such that the controller 24 communicates with thehospital information system 38 (see FIG. 1). In some embodiments, thecontroller 24 may be a microprocessor or generally any processingcomputer device. The network 36 may include one or more networks, suchas the Internet. In some embodiments, the network 36 may include one ormore wide area networks (WAN) or local area networks (LAN). The network36 may utilize one or more network technologies such as Ethernet, FastEthernet, Gigabit Ethernet, virtual private network (VPN), remote VPNaccess, a variant of IEEE 802.11 standard such as Wi-Fi, and the like.Communication over the network 36 takes place using one or more networkcommunication protocols including reliable streaming protocols such astransmission control protocol (TCP). As such, the transceiver 42 is anydevice capable of communicating with both the controller 24 and thenetwork 36, such as by the exemplary controllers and networks discussedbriefly above. The above examples of the controller 24, the network 36,and the transceiver 42 are illustrative and not intended to limit thepresent invention.

The sensor arrangement 12 a is positioned proximate to the mattress 26so as to detect the patient 22 on the mattress 26 and communicate thatdetection to the controller 24 in order to indicate whether or not thepatient 22 is in the predetermined position resting on the mattress 26with the sheet 16 positioned therebetween. Specifically, the sensorarrangement 12 a in conjunction with the controller 24 may be configuredto determine the patient's translational position relative to themattress 26, the patient's rotational position relative to the mattress26, or any combination thereof. After receiving instructionsautomatically or manually from at least one of the user interface 44 andthe hospital information system 38, the controller 24 directs the drivemechanism 28 to pull the sheet 16 only if the safety interlock 40communicates to the controller 24 that the appropriate conditions existfor the repositioning of the patient 22. For example, the safetyinterlock 40 may include more than one lock out condition for preventingoperation of the drive mechanism 28 by the controller 24, such as thebed head deck angle being too high, the sheet being improperly loaded,the absence of the patient 22 on the mattress 26, sheet contaminationsuch as by a contamination sensor (e.g., high moisture content, soiling,bacteria presence, ascetic detection, image detection, etc.), andimproper positions of a hinged access door 47 of the sheet receiver 14a. It will be appreciated that other lock out conditions may be usedand, as such, the invention is not limited to the safety interlock 40described herein.

With the conditions for repositioning the patient 22 determined to beappropriate by the controller 24 as signaled by the sensor arrangement12 a and the safety interlock 40, the controller 24 directs the drivemechanism 28 to pull the sheet 16. As discussed herein, the '185application describes one example of a patient repositioning system asfollows:

-   -   The mattress for repositioning the patient generally includes        the mattress foot end, the mattress head end, the upper surface,        and the pair of longitudinal sides as described above.        Generally, the pair of longitudinal sides is symmetric with a        generally uniform thickness, while the upper surface has a        substantially uniform width and length. The mattress is also        covered in an outer ticking for effectively improving the life        and comfort of the mattress. In addition, each of the retainers        is attached to the outer ticking of the mattress in spaced        relation along the length of the mattress longitudinal sides.        However, the mattress head end also includes a head end section        of reduced thickness relative to the generally uniform thickness        of the remaining mattress. In this respect, the head end section        is a relatively thin portion of the mattress and further        includes a head end piece. The head end piece folds about a fold        line relative to the rest of the mattress for improving access        to the sheet receiver below the upper surface of the mattress        head end. However, it will be appreciated that other respective        portions of the mattress may be otherwise movable for accessing        the sheet receiver.    -   Furthermore, at least a portion of the sheet receiver is        positioned within a volume envelope of the mattress for        effectively reducing an overall footprint of the mattress and        sheet receiver. The reduced thickness of the head end section        has a lower surface and a forward surface that collectively        define the volume envelope that would otherwise be occupied by        the mattress if not for the head end section of reduced        thickness. Thereby, the head end section is complementary in        shape to a housing of the sheet receiver.    -   The housing at least partially fits within the volume envelope        against the lower surface and the forward surface of the head        end section. The housing has a length substantially the same as        the width of the mattress and includes a slot extending        horizontally along the length of the housing. Additionally, the        housing includes an extension protruding horizontally along the        length of the housing and above the slot. According to an        exemplary embodiment of the invention, the extension defines a        lip against which the head end piece abuts when the sheet        receiver is positioned within the volume envelope.    -   The housing of the sheet receiver includes an access door        adjacent a top panel. The head end piece folds back at the fold        line to expose the access door that hingedly connects to the        housing. As such, the operator may move the access door by        pivoting it up and against the mattress to open the sheet        receiver. However, it will be appreciated that the access door        may be movable in any way relative to the remainder of the sheet        receiver to open the sheet receiver. For example, the access        door may be unitary with or connected to the head end piece such        that folding back the head end piece simultaneously opens the        access door. The access door opens at the slot for reducing the        number of openings into the housing. The open sheet receiver        exposes each of the components within a sheet chamber defined by        the housing. The sheet chamber includes a portion of the sheet        receiver that may that interact with the sheet, and thus, may        require periodic cleaning by the operator.    -   In this respect, the sheet receiver further includes a pulling        device operatively connected to the connecting structure that        operatively pulls the sheet into the sheet chamber. More        specifically, the pulling device includes a roller rotatably and        removably supported within the sheet chamber and generally        parallel to the slot. The roller includes a central portion and        opposing outer portions. Each first end of the pair of straps is        secured to the central portion of the roller via at least one        fastener. According to the exemplary embodiment of the        invention, the fastener is threaded and extends through the        first end and into the roller. Of course, it will be appreciated        that any structure or method of securing the straps to the        roller may be similarly used.    -   As the pulling device pulls the sheet into the sheet chamber,        the sheet is pulled to wrap about the roller. According to the        exemplary embodiment of the invention, engaged attachment of the        sheet to the sheet receiver occurs when the sheet sufficiently        wraps around the roller to transmit enough torque from the        roller to the sheet with enough force to pull the patient. More        particularly, the central portion is generally larger in        diameter than the opposing outer portions. On one hand, the        larger diameter of the central portion transmits torque to the        sheet while pulling both the sheet and the patient resting        thereon. On the other hand, the reduced diameter of the opposing        outer portions accommodates the excess width of the sheet for        both the sheet longitudinal sides and the beaded edges during        use. As such, most of the force required to pull the patient        transmits through the portion of the sheet on the upper surface        and about the head end section of the mattress, while less force        transmits through the sheet longitudinal sides.    -   In use, with a patient supported on the sheet and the sheet        located on the mattress, this patient repositioning system        enables an attendant to cause the sheet and the patient        supported thereon to move toward the head end of the mattress,        as the sheet is pulled into the slot formed in the housing.        Because the sheet has a width that is greater than that of the        mattress, and that additional width is retained along opposing        longitudinal sides of the mattress, as the sheet moves and the        patient is repositioned the outer portions of the sheet, i.e.        the sheet longitudinal sides move from a substantially vertical        orientation to a substantially horizontal orientation as the        sheet is pulled into the slot. For each sheet, a number of such        patient repositionings may occur, until the system indicates via        the sheet usage indicia that it is time to replace the sheet.        Generally, the attendant causes the sheet to move via operation        of the inputs to the drive mechanism, as described above.    -   To initiate patient repositioning using this system, an        attendant places a sheet on the mattress, connects the sheet to        the mattress, and also operatively couples the sheet to the        drive mechanism. Typically, this connecting of the sheet to the        mattress involves securing opposite sheet longitudinal sides of        the sheet to oppositely located rows of retainers spaced along        the length of the mattress, and the sheet has beaded edges along        its longitudinal sides which allow for longitudinal movement of        the sheet along the retainers. To operatively couple the sheet        to the drive mechanism, the attendant which may also be referred        to as an operator, releasably attaches the sheet to the drive        mechanism, and the drive mechanism is then used to pull the        sheet toward the head end of the mattress, to “load” the sheet        in preparation for subsequent pullings of the sheet toward the        head end of the mattress with a patient residing thereon.

With respect to FIG. 3A, the patient 22 is shown after migrating from ahead end 48 of the mattress 26 toward a foot end 50 of the mattress 26.In other words, the patient 22 is in the undesirable position with anincreased risk of injury and discomfort. The drive mechanism 28 therebypulls the sheet 16, as indicated by arrow 52, about the head end 48 ofthe mattress 26, through a slot 54 in the housing 29, and into the sheetreceiver 14 a. Thereby, the patient 22, resting directly on the sheet16, is similarly pulled toward the head end 48 of the mattress 26 untilthe patient 22 reaches the predetermined position.

The sensor arrangement 12 a configured to sense the position of thepatient 22 relative to the mattress 26 is shown in FIG. 4. The sensorarrangement 12 a includes the sensors 20 positioned on an upper surface56 of the housing 29, a lower surface 58 or inner region of the mattress26, and on a bed deck 59 of the health care bed 18. More particularly,sensors 20 are positioned on respective head and foot ends 48, 50 of themattress 26 and on a head deck portion 60, a central deck portion 62,and a foot deck portion 64, respectively for sensing the patient'sposition along substantially the entire top surface of the mattress 26.

The sensor arrangement 12 a senses the position of the patient 22 bydetecting patient weight along the health care bed 18 and communicatingthe detected weight to the sheet receiver 14 a. As shown in FIG. 5A,each of the sensors 20 is in the form of a capacitive sensor 20. Theforce of the patient's weight sandwiches a top contact 66, a compressivedielectric material 68, and a bottom contact 70 together. As such, thecapacitive sensor 20 detects a change in capacitance value forcommunication to the controller 24. The controller 24 collects theinformation from each of the sensors 20, analyzes the collectiveinformation regarding the weight distribution of the patient 22 asdetected by the sensors 20, and determines the patient position based ondetected capacitance from the entirety of the sensor arrangement 12 a.

According to another exemplary embodiment shown in FIG. 5B, a sensor 120is in the form of a resistive sensor 120. The force of the patient'sweight directs a top contact 166 against a bottom contact 170. As such,the resistive sensor 120 detects a change in resistance value forcommunication to the controller 24. The controller 24 collects theinformation from each of the sensors 120, analyzes the collectiveinformation regarding the weight distribution of the patient 22 asdetected by the sensors 120, and determines the patient position basedon detected resistance from the entirety of the sensor arrangement 112a.

FIG. 6 shows a second embodiment of a sensor arrangement 212 aintegrated within the health care bed 18. The sensor arrangement 212 aincludes a plurality of sensors 220, which are each in the form ofstrain gages 220. The force of the patient's weight effectively bendsthe strain gauge 220 so as to change a resistance value of the straingauge 220. As such, the strain gauge 220 detects the changing resistancevalues for communication to the controller 24. In addition, straingauges 220 have been included on pedestals 271 positioned between thebed deck 59 and a remaining frame 272 of the health care bed 18supporting the bed deck 59 thereon. The controller 24 collects theinformation from each of the sensors 220, analyzes the collectiveinformation regarding the weight distribution of the patient 22 asdetected by the sensors 220, and determines the patient position basedon detected resistance values from the entirety of the sensorarrangement 212 a.

A third exemplary embodiment of a sensor arrangement 312 a is shown inFIGS. 7-8B. The sensor arrangement 312 a includes a plurality of sensors320, which are each in the form of a light sensor 320. A light source374 directs light, as indicated by arrows 376, along fiber-optic cable378. The force of the patient's weight effectively bends the fiber-opticcable 378 so as to change an amount of light passing through thefiber-optic cable 378. As such, the light sensor 320 detects thechanging light values for communication to the controller 24. Thecontroller 24 collects the information from each of the sensors 320,analyzes the collective information regarding the weight distribution ofthe patient 22 as detected by the sensors 320, and determines thepatient position based on detected light from the entirety of the sensorarrangement 312 a.

A fourth exemplary embodiment of a sensor arrangement 412 a is shown inFIG. 9. The sensor arrangement 412 a includes a plurality of sensors420, which are each in the form of an optical sensor 420. Generally, theoptical sensors 420 work in opposing pairs such that an infrared beam(not shown) is directed therebetween. The presence of the patient 22between the pair of optical sensors 420 interrupts the infrared beam soas to indicate the position of the patient 22. As such, the opticalsensors 420 detect the changing infrared beam for communication to thecontroller 24. The controller 24 collects the information from each ofthe sensors 420, analyzes the collective information regarding blockageand/or non-blockage of the infrared beams by the patient 22 as detectedby the sensors 420, and determines the patient position based on thedetected infrared beams from the entirety of the sensor arrangement 412a.

In addition, the sensor arrangement 412 a further includes a camera 480positioned proximate to the mattress 26 for viewing the patient 22 onthe mattress 26. For example, the camera 480 may be attached to thehealth care bed 18 or on a surface within the facility, such as a headwall, foot wall, ceiling, or other location proximate to the bed 18. Thecamera 480 visually collects light representing the patient 22 anddirects the representation to the controller 24. The controller 24 isfurther configured to analyze the representation and identify theposition of the patient 22 relative to the mattress 26.

This specification shows and describes several embodiments of theinvention. However, those skilled in the art will appreciate that thedisclosed embodiments are susceptible to a reasonable amount ofmodification and/or permutation, without departing from the overallscope of the invention. By way of example, the operative connectionsdescribed herein may be either wired or wireless. Any number, locations,and combination of sensors 20, 120, 220, 320, 420 may be used inaccordance with the invention discussed herein. For example, one of thesensor arrangements 412 a, such as the camera 480, may be used incombination with any of the other sensors 20, 120, 220, 320. By way forfurther example, fewer sensors 20, 120, 220, 320, 420 may be more costeffective in some applications, whereas more sensors 20 may providebetter resolution of the patient's position in other applications.Furthermore, the actual conversion of the individual sensor 20, 120,220, 320, 420 outputs may be accomplished by controller 24 or a separateadditional controller dedicated to only performing the patient 22position calculation. This additional controller would then communicatethe position of the patient 22 to controller 24 using a wired orwireless communication path. Furthermore, the reference to the “sensors”is not intended to limit the invention only to the sensors 20, 120, 220,320, 420 shown and described herein. Rather, any sensor capable ofdetecting the position of the patient 22 (e.g., magnetic sensing ofheart location, fluid flow detection within the body and hence locationof organs by acoustic/Doppler/ultrasonic detection of location of majororgans, etc.), in whole or in part, may be used in accordance with theinvention described herein.

We claim:
 1. A patient monitoring and repositioning system incombination with a bed having a deck, comprising: a mattress residing onthe deck and having a head end, a foot end, and an upper surface; asheet residing on the upper surface; a drive mechanism located near thehead end of the mattress and operable to pull the sheet toward the headend of the mattress to thereby reposition the sheet relative to themattress, and also reposition a patient residing on the sheet; a housingcontaining the drive mechanism, the housing including a slot extendingtherealong, and the drive mechanism being operable to pull the sheetinto the housing via the slot, the housing further including an accessdoor movable relative to the housing to thereby permit access to theinside of the housing; and a sensor operatively connected to the drivemechanism, the sensor adapted to sense a position of the patientrelative to the mattress on the bed and to generate a signal in responseto the patient moving from a predetermined position.
 2. The patientmonitoring and repositioning system of claim 1 wherein the drivemechanism pulls the sheet so as to reposition the patient to thepredetermined position upon receiving the signal from the sensor.
 3. Thepatient monitoring and repositioning system of claim 2 wherein thesensor also senses that the patient is in the predetermined positionafter the drive mechanism has pulled the sheet so as to reposition thepatient thereto.
 4. The patient monitoring and repositioning system ofclaim 1 wherein the sensor continuously senses the position of thepatient relative to the mattress.
 5. The patient monitoring andrepositioning system of claim 1 further comprising: an indicatoroperatively connected to the sensor and which includes at least one of:an LED, a graphic display, an audible signal, a wired message, and awireless message.
 6. The patient monitoring and repositioning system ofclaim 5 wherein the indicator indicates the position of the patient atall times.
 7. The patient monitoring and repositioning system of claim 5wherein the indicator indicates when the patient is in the predeterminedposition.
 8. The patient monitoring and repositioning system of claim 5wherein the indicator indicates when the patient is not in thepredetermined position.
 9. The patient monitoring and repositioningsystem of claim 1 further comprising: a controller operatively connectedto the drive mechanism and the sensor.
 10. The patient monitoring andrepositioning system of claim 9 wherein the controller is located on atleast one of the housing and the bed and is operable to cause the drivemechanism to reposition the patient upon receiving the signal from thesensor that the patient has moved from the predetermined position. 11.The patient monitoring and repositioning system of claim 9 wherein thecontroller is located on at least one of the housing and the bed and isoperatively connected to a user interface comprising at least one of: aswitch, and a graphic touchscreen panel.
 12. The patient monitoring andrepositioning system of claim 11 wherein the controller is operative toreceive an input from a caregiver via the user interface to cause thedrive mechanism to reposition the patient.
 13. The patient monitoringand repositioning system of claim 9 wherein the controller is locatedremotely and operable to cause the drive mechanism to reposition thepatient upon receiving the signal from the sensor that the patient hasmoved from the predetermined position.
 14. A plurality of the patientmonitoring and repositioning systems of the type described in claim 9and further comprising: a central control system operatively connectedto the controllers of the plurality of patient monitoring andrepositioning systems, for monitoring the positions of a plurality ofpatients located respectively on a plurality of beds, thereby for eachof the patient monitoring and repositioning systems to enable theongoing monitoring of at least one of: the patient not in thepredetermined position, a time that the patient is not in thepredetermined position, an amount of patient repositionings, a frequencyof patient repositionings in a facility, an amount of sheet alreadyused, a need to change or reset the sheet on the bed, a distancemigrated by the patient on the bed, a time of the patient in eachposition on the bed, a time delay before repositioning the patient onthe bed, a duration of repositioning the patient on the bed, theposition of the patient on the bed, a time of day the patient wasrepositioned, and a frequency of patient repositionings executed on thebed.
 15. A method of monitoring and repositioning a sheet that islocated on a mattress, the mattress having a head end and a foot end andbeing supported by a bed frame, comprising: causing the sheet and apatient supported thereon to move toward the head end of the mattress,whereby the causing further includes pulling the sheet into a slotformed in a housing located adjacent the head end of the mattress, thesheet being retained along opposing longitudinal sides of the mattress;and prior to the causing, sensing a position of the patient anddetermining that the sensed position of the patient differs from apredetermined position on the mattress; after the causing, determiningthat the patient is in the predetermined position.
 16. The method ofclaim 15 wherein the causing is initiated by a caregiver positionedproximate to the mattress and the method further comprises: indicatingto the caregiver that the patient is in the predetermined position. 17.The method of claim 15 wherein the causing is initiated by a caregiverpositioned remotely from the mattress and the method further comprises:indicating to the caregiver that the patient is in the predeterminedposition.
 18. The method of claim 15 wherein the housing is locatedbelow the upper surface of the mattress and the sheet has a widthgreater than that of the mattress.
 19. The method of claim 15 furthercomprising: activating an indicator when the patient is sensed to be inthe undesirable position relative the predetermined position on to themattress.
 20. The method of claim 15 further comprising: monitoring, viaa controller, the sensing and the causing.
 21. The method of claim 18wherein the controller is located proximate to the bed and is capable ofautomatically repositioning the patient.
 22. The method of claim 18wherein the controller is located remotely from the bed and communicatestherewith via a wired or a wireless connection.
 23. The method of claim18 wherein a central controller operatively connects to a plurality ofcontrollers, each of the controllers respectively associated with apatient monitoring and repositioning system and further comprising:using the central controller to monitor at least one of the following:the positions of a plurality of patients located respectively on aplurality of beds, thereby for each of the patient monitoring andrepositioning systems to enable the ongoing monitoring of at least oneof: the patient not in the predetermined position, a time that thepatient is not in the predetermined position, an amount of patientrepositionings, a frequency of patient repositionings in a facility, anamount of sheet already used, a need to change or reset the sheet on thebed, a distance migrated by the patient on the bed, a time of thepatient in each position on the bed, a time delay before repositioningthe patient on the bed, a duration of repositioning the patient on thebed, the position of the patient on the bed, a time of day the patientwas repositioned, and a frequency of patient repositionings executed onthe bed.
 24. The patient monitoring and repositioning system of claim 9wherein the controller is located remotely from the bed and is alsooperatively connected to a user interface comprising at least one of: aswitch, and a graphic touchscreen panel, and wherein the controller isoperative to receive an input from a caregiver via the user interface tocause the drive mechanism to reposition the patient.
 25. The patientmonitoring and repositioning system of claim 9 wherein the controllermonitors at least one of: the patient not in the predetermined position,a time that the patient is not in the predetermined position, an amountof patient repositionings, a frequency of patient repositionings, anamount of sheet already used, a need to change or reset the sheet on thebed, a distance migrated by the patient on the bed, a time of thepatient in each position on the bed, a time delay before repositioningthe patient on the bed, a duration of repositioning the patient on thebed, the position of the patient on the bed, a time of day the patientwas repositioned, and a frequency of patient repositionings executed onthe bed.
 26. At least one patient monitoring and repositioning system ofthe type described in claim 9 and further comprising: a central controlsystem operatively connected to the controller of the patient monitoringand repositioning system, for monitoring the position of a patientlocated on the bed, thereby to enable the ongoing monitoring of at leastone of: the patient not in the predetermined position, a time that thepatient is not in the predetermined position, an amount of patientrepositionings, a frequency of patient repositionings, an amount ofsheet already used, a need to change or reset the sheet on the bed, adistance migrated by the patient on the bed, a time of the patient ineach position on the bed, a time delay before repositioning the patienton the bed, a duration of repositioning the patient on the bed, theposition of the patient on the bed, a time of day the patient wasrepositioned, and a frequency of patient repositionings executed on thebed.